<div  class="fui-page order-create-page fui-page-current">
	<div class="fui-content navbar" style="top:2rem">
		<div class="weui_cells weui_cells_form">
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">姓名</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" type="text" ng-model="pagedata.member.name" placeholder="请输入您的真实姓名">
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">手机</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" type="number" ng-model="pagedata.member.mobile" placeholder="请输入您的手机号码">
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">身份证号</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" type="text" ng-model="pagedata.member.idcard" placeholder="请输入您的身份证号">
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd">
							<label class="weui_label">性别</label>
						</div>
						<div class="weui_cell_bd weui_cell_primary">
							<select class="weui_select" name="select2"  ng-model="pagedata.member.sex">
								<option value="1">男</option>
								<option value="2">女</option>
								
							</select>
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">车牌号</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" type="number" ng-model="pagedata.member.carid" placeholder="请输入您的车牌号">
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">公司编号</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" type="number" ng-model="pagedata.member.cid" placeholder="请输入您的公司编号">
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">保险单号</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" type="text" ng-model="pagedata.member.bx" placeholder="请输入您的保险单号">
						</div>
					</div>
					<div class="weui_cell weui_vcode">
						<div class="weui_cell_hd"><label class="weui_label">现住地址</label></div>
						<div class="weui_cell_bd weui_cell_primary">
							<input class="weui_input" ng-model="pagedata.member.address" placeholder="请输入您的现住地址">
						</div>
					</div>
		</div>
		<div class="weui_btn_area">
				 <a class="weui_btn weui_btn_primary" href="javascript:" id="showTooltips" ng-click="post(pagedata.member,'set')">提交</a>
		</div>
</div>
</div>
<div ng-include="sys_html('_menu')"></div>